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    Why are they paid so much? In the US they can earn around $461,000. In the UK, (correct me if I'm wrong) all specialities earn a base salary of around £70,000 and they can earn more by doing private work.

    Source:
    https://www.ncbi.nlm.nih.gov/pmc/art...43/table/tbl3/

    Also, why do all medical specialities have approximately the same salary?
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    (Original post by rickyrossman)
    Why are they paid so much? In the US they can earn around $461,000. In the UK, (correct me if I'm wrong) all specialities earn a base salary of around £70,000 and they can earn more by doing private work.

    Source:
    https://www.ncbi.nlm.nih.gov/pmc/art...43/table/tbl3/
    Well it's more like £76K to start with, and that's the salary for a consultant in the first year of their practice in England:

    https://www.bma.org.uk/advice/employ...ts-pay-england

    As you say, private work is certainly a possibility in the UK too.

    As for why surgeons earn more in the US - well for a start it's not just surgeons, all US consultants earn more than their UK counterparts. The system of medicine there is a lot more revenue and profit oriented and you can earn a good deal by charging per procedure/operation, particularly if you can keep your other risks and costs relatively low. Which is the part of the same principle that private medicine here works on too.

    On the other hand, the US has a much bigger suing and negligence culture than we have here in the NHS, so whilst they may make a lot more money in some respects, they might also end up paying out more via other routes. Historically I think the average US medical school graduate had more debt than their UK equivalent, but in the current era that's probably becoming less of a significant difference.

    Also, why do all medical specialities have approximately the same salary?
    Tell me why they shouldn't?
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    (Original post by Democracy)
    Tell me why they shouldn't?
    Well spoken for.
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    (Original post by Democracy)
    Tell me why they shouldn't?
    Honestly, I don't know, I'm just curious.
    In the US you can earn as little as $175,000 as a pediatric or $500,000 as a neurosurgeon. Aren't some specialities also harder and more stressful?
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    (Original post by rickyrossman)
    In the US you can earn as little as $175,000 as a pediatric or $500,000 as a neurosurgeon. Aren't some specialities also harder and more stressful?
    That's a good example actually as it shows precisely what's so bonkers and arbitrary about equating income with the stress and difficulty associated with a specialty.

    In other words, does anyone actually think being a paediatrician is only 35% as stressful as being a neurosurgeon? If so, they've clearly not seen enough paeds(!)
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    (Original post by rickyrossman)
    Also, why do all medical specialities have approximately the same salary?
    This is a much better question than @Democracy has given you credit for. The honest answer is that the profession (through the British Medical Association) has always opposed the idea that doctors in some specialties should be paid differently to others. This is partly because it would make it very difficult to bargain collectively if we all split off into different factions competing for higher amounts from the same overall pay envelope.

    It is an open secret that this upsets some specialties - the Royal College of Surgeons of England in particular lobby behind the scenes for varying T&Cs.

    There are lots of reasons why specialties could be paid differently as they differ a lot in terms of difficulty (physically and intellectually), time spent in training, how many jobs are available (i.e. the market need), how much revenue they generate for their trust (some services are remunerated more generously than others), etc.

    On the flip side, it is nice to be able to choose your specialty as a UK graduate for the job itself and not because you need to pay off your student loan quickly.
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    (Original post by Democracy)
    That's a good example actually as it shows precisely what's so bonkers and arbitrary about equating income with the stress and difficulty associated with a specialty.

    In other words, does anyone actually think being a paediatrician is only 35% as stressful as being a neurosurgeon? If so, they've clearly not seen enough paeds(!)
    (Original post by MonteCristo)
    There are lots of reasons why specialties could be paid differently as they differ a lot in terms of difficulty (physically and intellectually), time spent in training, how many jobs are available (i.e. the market need), how much revenue they generate for their trust (some services are remunerated more generously than others), etc.
    I second MonteCristo's points, especially about training length. Even as someone with zero interest in surgery, it does seem slightly unfair that a gen surg consultant gets the same initial contract as a pathologist would despite requiring 3 years more of training (in terms of minimum training lengths).

    It does mean we get a reasonably fair spread of quality across specialties though. Unlike the US where there is a heavy skew of higher scoring graduates in certain fields.

    TO address OP:

    on average, remember US med school is 4 years of undergrad + 4 years of medical school. Average US medical graduate has roughly USD 200-230k (roughly 140k sterling) debt. Compare that to roughly less than half of that, even with the new fees + fixed repayment limits mean there's less outright difference.

    Unlike the UK, as mentioned above, you are compensated more or less directly by the revenue you pull in. This could be via the number of patients seen/day, procedures done etc.

    And UK on average has lower salaries across all fields than their American counterparts for graduate level jobs. Finance, engineering, IT sector jobs all get less than their American counterparts. Even at CEO levels. Conversely, low-income jobs are higher than their American counterparts. Come to think about it, that actually pretty much mirrors the medical specialties too...
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    (Original post by hslakaal)
    I second MonteCristo's points, especially about training length. Even as someone with zero interest in surgery, it does seem slightly unfair that a gen surg consultant gets the same initial contract as a pathologist would despite requiring 3 years more of training (in terms of minimum training lengths).

    It does mean we get a reasonably fair spread of quality across specialties though. Unlike the US where there is a heavy skew of higher scoring graduates in certain fields.
    I don't really see why there should be a link between one's NHS salary and what's gone on before in training, especially when all the arguments I've heard to support that position sound rather arbitrary.

    I think the FRCPath is an academically more difficult qualification than the FRCS - would you agree that some sort of consideration should be made for that?

    And what about the private earning potential of surgeons which far outstrips that of histopathologists? Those three extra SpR years are fairly irrelevant when considered as part of a 40 year career. Fair enough if surgeons want to make a mint privately but I don't see why the NHS should also chip in with that.

    I don't disagree with the points which MonteCristo makes, I'm actually broadly in agreement with the BMA's point here. I've not really ever heard any convincing arguments as to why different specialties should be paid hugely differently in the NHS which don't boil down to a) revenue based arguments which seem less relevant in a (supposedly) nationalised health service or b) just sound really over-simplified and like what applicants on here suggest when they discuss which specialties are the "best".

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    (Original post by Democracy)
    I don't really see why there should be a link between one's NHS salary and what's gone on before in training, especially when all the arguments I've heard to support that position sound rather arbitrary.

    I think the FRCPath is an academically more difficult qualification than the FRCS - would you agree that some sort of consideration should be made for that?

    And what about the private earning potential of surgeons which far outstrips that of histopathologists? Those three extra SpR years are fairly irrelevant when considered as part of a 40 year career. Fair enough if surgeons want to make a mint privately but I don't see why the NHS should also chip in with that.

    I don't disagree with the points which MonteCristo makes, I'm actually broadly in agreement with the BMA's point here. I've not really ever heard any convincing arguments as to why different specialties should be paid hugely differently in the NHS which don't boil down to a) revenue based arguments which seem less relevant in a (supposedly) nationalised health service or b) just sound really over-simplified and like what applicants on here suggest when they discuss which specialties are the "best".

    Well, the only reason for it being that that's the only "metric" that is relatively impartial. It'll be hard to objective say a specialty is harder than another.

    When you consider that a lot of pay banding across a lot of the NHS workforce is fairly time dependent (or at least was, till the new contracts I guess), not to mention that even consultant pay is fairly dependent on no. years after CCT (+ market factors as well, but generally speaking), it doesn't seem too unfair imho. Private income is debatable though. What about general paeds where training is longer with minimal private practice. All I'm pointing out is just one of the inequality from one specific angle, that is easily comparable. One of the slight downsides of the new contract imho. It just seems slightly unfair that financially speaking, you are penalised for doing a longer training programme. Of course, most of these still attract large numbers, so isn't an issue. Just a philosophical thought about parity.

    I completely understand your point. There's ultimately no real right or wrong way. Just food for thought really.
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    Remember when you see a $500k salary for a US neurosurgeon vs $175k for family medicine or whatever, there's a massive difference in hours worked there. Yes there is a difference in income by specialty, but once you account for time worked it's not such a marked difference.
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    more responsibility = more money

    bigger country = more jobs with lots of responsibility

    lower minimum wage and no annual leave requirements = organisations spent a greater percentage of their wealth paying top employees and management
 
 
 
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